A regular exercise regimen is often recommended for people to promote better overall health and fitness. For those who are in relatively good physical shape and have no significant limitations for positioning their bodies, engaging in regular exercise is not much of an issue.
Physical therapy is a well established branch of medicine and is designed to help people with medical issues function at a higher level. This is accomplished through specifically prescribed exercises with certain contraindications for movement. For instance, individuals with osteoporosis may need to extend their spines more frequently and to avoid flexion of the spine. Conversely, individuals with stenosis of the spine may need to do more flexion exercise and avoid extension. Unfortunately, the dual diagnoses of both spinal stenosis and osteoporosis in an individual are not uncommon. For those individuals prescribing a regimen of abdominal strengthening and spinal extension exercises to be performed at home typically presents a challenge to physical therapists especially considering the lack of suitable and affordable exercise equipment available for in home use.
If an individual diagnosed with the dual diagnosis attempts to do traditional exercises, such as trunk crunches or sit-ups for abdominal strengthening, the flexion of the spine that will occur is contraindicated. The physical therapist will often prescribe spinal stabilization exercises for these individuals. The premise of spinal stabilization exercise is finding “neutral spine” (see the Terminology section in this disclosure, infra), and then maintaining that “neutral spine” in various positions during various activities. In one exercise used to stabilize and strengthen the spine a patient is directed to place his or her spine in a neutral position by laying in a supine position, and then move an arm and or leg away from the body. This movement causes a lever arm of force that challenges the maintenance of “neutral spine”. By resisting and maintaining the “neutral spine” position during the exercise, the patient will improve his or her abdominal strength and postural awareness. However, It can be difficult for a patient to establish the “neutral spine” location when lying supine without additional support. Another exercise often prescribed for an individual with the aforementioned dual diagnoses this often prescribed exercise has the individual assume a prone position on a mat wherein he or she lifts and moves his or her arms, legs and/or trunk. This can be problematic as lifting an arm, leg and/or trunk while lying on a mat will often move his/her spine into extension which is also contraindicated. Essentially, when an individual having the dual diagnosis lies prone with his or her spine is close to neutral, tightness in the anterior hip muscles may place the lumbar spine in an initial state of extension. Any subsequent or additional movement upward as required in performing the stabilization exercise increases the extension moment at the spine. As with the first exercise, a support device may be required to help the individual maintain the neutral spine position and maximize the benefit of the exercise.
Therapy balls (also referred to as Swiss ball), arc barrels and half domes (such as a BOSU® manufactured by Bosu Fitness, LLC of Delaware) can be used to support and alter the start position of the spine to a slightly flexed position allowing the individual to lift his arm, leg, trunk to “neutral spine”. However, there are shortcomings to the use of these devices.
Therapy balls typically comprise inflated spheres having elastomeric skins that are about 18-30 inches in diameter. The shortcoming of using a therapy ball to alter a person's start position is that it can create excessive pressure at the area of contact with a prone-lying individual secondary to the firmness of a fully inflated ball. Further due to the ball's shape, an individual may have difficulty achieving the supine or side-lying positions to perform basic stabilization exercise. Finally, a therapy ball is inherently unstable and can cause an individual to fall while exercising.
An arc barrel is a longitudinal partial cylinder (typically a half cylinder or less) that is of used in Pilates to help support persons performing various exercises. A typical arc barrel is short in height usually 6 inches in height making it difficult for people with stiffness in their spine, hips and/or knees to get down on the floor to exercise. Furthermore, arc barrels typically lack softness and conformability, as they are often constructed from wood covered only with vinyl and a thin layer of padding. When a person lies prone over an arc barrel the combination of excessive firmness, short height and symmetrical sloping angles (or arcs) creates unwanted pressure in sensitive areas of the abdomen often causing discomfort.
A half-dome (or BOSU® or fitness dome) is an inflated half-sphere that has a symmetrical shape and symmetrical sloping angles (arcs). A typical half-dome is short in height (often only about 12 inches) that also makes it difficult to use by individuals who suffer from stiffness in their spine, hips and/or knees and often have trouble getting down on the floor to exercise. Moreover, like an arc barrel, a typical half-dome virtually lacks any significant softness and conformability as it is meant to be used while fully inflated, and thus are very firm. The symmetrical configuration, short height and firmness can create a focal area of pressure against the sensitive abdominal region in the prone lying individual. Additionally, the half-dome (and for that matter, arc barrel) are produced with a “one-size-fits-all” mentality even though individuals have different torso lengths. These different torso lengths can make for a dramatically different exercise experience for the short-waisted individual compared to the long-waisted individual.
A support device is needed that better facilitates exercise by individuals with flexibility and/or medical issues of the type described above. Ideally, the improved support device would be inherently stable and decrease the pressure felt by the individual by providing a larger contact area or interface between the device and the individual during exercise.